華盛頓——美國疾病控製預防中心(CDC)的最新數據顯示，去年大約42%的美國人和67%的醫務人員接種了流感疫苗。
美國國家傳染性疾病基金會(NFID)前主席、範德堡大學預防醫學係主任、教授William Schaffner博士在新聞發布會上稱，自2010年CDC推薦6個月及以上所有人群接種廣譜流感疫苗以來，美國流感預防工作已逐步走向正軌，但仍有許多改善空間，而臨床醫生在這項工作中起著關鍵性作用。
Schaffner博士認為，醫務人員預防接種兼有倫理和職業雙重責任。原因有二：首要也是最重要的是患者安全問題，醫務人員不能將流感傳播給患者；另一原因是，當流感來襲時，醫務人員不能病倒，而應該向大眾提供醫療服務。
眾多因素使得人們目前接種流感疫苗比以前更為容易，這些因素包括疫苗供應充足和接種地點多樣化，例如人們可以在工作場所進行接種。此外，正確的洗手方法、咳嗽及打噴嚏禮儀以及及時使用抗病毒藥物等對於預防和控製流感傳播也至關重要。
William Schaffner博士
美國醫學會(AMA)的Litjen Tan博士認為，對於哪些對流感疫苗接種持觀望態度的患者而言，醫生的建議可能具有決定性作用。CDC最新資料顯示，孕婦得到醫生推薦後接種幾率提高5倍，44%的未打算接種疫苗的65歲以上成人在得到醫生推薦後接種了疫苗。他指出，每位醫生在流感季節均有機會提醒患者接種疫苗，心髒病、婦產科、胸肺科以及內分泌科醫生應建議其高危患者在可能的情況下盡快接種流感疫苗。
CDC國家免疫與呼吸疾病中心的Daniel Jernigan博士稱，本流感季節大約已有850萬劑流感疫苗供應到位，加之尚在運輸途中的疫苗，共計約1350萬劑。今年的疫苗含有一種新型流感A和一種新型流感B病毒株，但截至目前僅發現少數上述病毒株。他表示，雖然最佳接種時間是在流感季節開始之前，但鑒於難以確定流感從何時何地開始，所以建議在整個流感季節期間均可接種疫苗。
美國健康和人類服務部的Howard Koh博士指出，盡管去年流感季節是自1982年以來最為溫和的一年，但醫生不應對自己及其患者的接種情況感到自滿。近年來的情況表明流感是不可預測的，2009~2010年流感大流行後2011~2012年流感季節異乎尋常溫和，但流感相關的住院和死亡病例每年均有發生。他強調說，我們不能依據過去預測未來。
Koh博士還重點介紹了近來接種覆蓋率方麵取得的進展情況，相關數據在線發表在9月27日的《發病率與死亡率周報》上(2012;61:753-63)。
總體上，在2011~2012流感季節， 6個月~17歲兒童接種率為52%，6~23個月兒童接種率為75%，與上一季度相當。但青少年接種率仍麵臨挑戰，13~17歲兒童接種率僅為34%。去年65歲及以上成人接種率為65%，比2008~2009流感季節的74%有所下降。孕婦接種覆蓋率與上一年度相當，為47%，仍明顯高於2008~2009年流感季節之前的30%。連續第2年未見兒童接種率存在種族或族裔差異，盡管成人間的差異仍然存在。
新聞發布會由NFID讚助。有關醫務人員和孕婦流感疫苗接種情況的完整報告參見MMWR網站。
By: HEIDI SPLETE, Clinical Endocrinology News Digital Network
WASHINGTON – Approximately 42% of the U.S. population and 67% of health care workers received influenza vaccinations last year, according to data from the Centers for Disease Control and Prevention.
Since the CDC’s 2010 recommendation for universal flu vaccination for everyone aged 6 months and older, "we seem to be on track in protecting the nation against influenza," Dr. William Schaffner, past president of the National Foundation for Infectious Diseases, said at a press conference.
But there is room for improvement, and clinicians play a key role, said Dr. Schaffner, who also serves as a professor and chair of preventive medicine at Vanderbilt University in Nashville, Tenn.
"I believe that the immunization of the health care provider community is both an ethical and professional responsibility," he said. "It is for two reasons: The first and most important is a patient safety issue, so we do not transmit our influenza infection to our patients."
"The other reason is, when influenza strikes, we need to be vertical, not horizontal," he continued. "We need to be ready to provide health care during that period of great community stress."
"There are many factors that make it easier than ever for everyone to receive flu vaccination," including a plentiful vaccine supply and a variety of venues, including workplaces, where individuals can be vaccinated, said Dr. Schaffner. Proper handwashing, cough and sneeze etiquette, and the prompt use of antivirals also are important to prevent and limit the spread of the flu.
"A physician’s recommendation can be the deciding factor for patients who are sitting on the fence" about getting a flu vaccination, said Litjen Tan, Ph.D., director of medicine and public health for the American Medical Association.
Recent CDC data indicate that pregnant women whose doctors recommended flu vaccination were five times as likely to get a vaccination, and 44% of adults above age 65 who didn’t intend to get vaccinated did so when a doctor recommended it, Dr. Tan said.
"Every physician has an opportunity this flu season to remind their patients to get vaccinated," he said. "Physicians such as cardiologists, obstetricians and gynecologists, pulmonologists, and endocrinologists, who all have high-risk patients, should encourage their patients to seek influenza vaccinations as soon as they are available."
Approximately850萬85 million doses of flu vaccine have been distributed so far this season, with more on the way, for a total of about 135 million doses, said Dr. Daniel Jernigan, deputy director of the influenza division in the CDC’s National Center for Immunization and Respiratory Diseases.
"The best time to get vaccinated is before the flu season starts," he said. "It is hard to know when the flu will start and where it will start," but vaccination is still recommended throughout the flu season.
This year's vaccine contains a new A virus and a new B virus.
"The few strains we have seen so far match what’s in the vaccine," Dr. Jernigan said.
Although last year’s flu season was the mildest since 1982, clinicians should not be complacent about vaccination for themselves and their patients, said Dr. Howard Koh, assistant secretary for health at the U.S. Department of Health and Human Services.
"The last few years have demonstrated that the flu is predictably unpredictable," Dr. Koh said. The flu pandemic of 2009-2010 was followed by an unusually mild flu season in 2011-2012, but flu-related hospitalizations and deaths occur every year.
"We can’t look to the past to predict the future," he emphasized.
Dr. Koh highlighted data on the recent progress in vaccination coverage, which appeared in Morbidity and Mortality Weekly Report online Sept. 27 (2012;61:753-63).
Overall, 52% of children aged 6 months to 17 years were vaccinated during the 2011-2012 season, approximately the same rate as the previous year, with a rate of 75% among children aged 6 months to 23 months.
However, vaccination of adolescents remains a challenge; 34% of children aged 13-17 years were vaccinated, said Dr. Koh. Adults aged 65 years and older had a 65% vaccination rate last year, but this was a drop from 74% in 2008-2009.
Vaccination coverage among pregnant women was consistent with the previous year, at 47%, remaining significantly higher than the 30% rate before the 2008-2009 flu season.
For the second year in a row, no racial or ethnic disparities were seen in vaccination rates for children, although these disparities persist among adults, Dr. Koh said.
The press conference was sponsored by the National Foundation for Infectious Diseases. For the complete report on flu vaccination in health care personnel and in pregnant women, visit the MMWR website here.
